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Washington State Dental Association

Medicaid Provider Update

As of July 1, 2016, the Washington State Health Care Authority (HCA) will implement changes to fee-for-service Spenddown. Changes include removing the claim comment “SCI=Y” and updating the comment to Spenddown. These changes will be reflected in the HCA’s Provider Guides available on HCA’s website on July 1, 2016.

Additionally, the HCA recently updated their Denture or Partial Agreement (HCA 13-809) form. The form will now have two new sections: 

• Section 1, Wax Try-In
• Section 2, Delivery and Seating of Denture(s)

According to the HCA, “providers must review both sections with the client and obtain signatures from the client at the wax try-in visit and at time of delivery. The signature date from the time of delivery must match the date of service on the billing. The form must be completed, kept in the client’s file, and made available to the Health Care Authority (the agency) upon request.”

Providers will need to start using the updated form starting August 1, 2016. 

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